Clinical Reasoning on an Assignment: Baccalaureate Nursing Students’ Perceptions

Abstract

Baccalaureate nursing students must develop strong clinical reasoning skills to make sound clinical judgments regarding patient care. The purpose of this Interpretive Descriptive qualitative study was to explore how students understand the evolution and application of their own clinical reasoning skills. Eight nursing students were interviewed about their perceptions regarding the use of clinical reasoning skills on a written, patient scenario based assignment. An overarching theme of “over time” emerged along with two themes: “understanding of clinical reasoning” and “making sense of the assignment.” Sub-themes were identified as “not knowing,” “knowing,” “applying knowing,” and “valuing knowing.” Students understood their clinical reasoning skills to have progressed throughout their educational program; perceived that their understanding of the patient’s problem and the required nursing actions deepened over the time of writing the assignment; perceived they were able to apply learning from the assignment to their nursing practice; and perceived writing the assignment to be a stressful experience. Implications for nursing education include leveling of assignments; completing the assignment in pairs or small groups to improve learning and decrease stress; and the incorporation of virtual patient or high-fidelity simulation to improve the visual and unfolding elements of a patient scenario based clinical reasoning assignment.